PKB supports trusts' elective recovery plans for Outpatient Optimisation with our understanding and experience with patient remote follow-up, reducing the amount of outpatient appointments needed knowing patients can have their care delivered at home through PKB.
PKB supports trusts to optimise outpatient clinics in many ways, such as optimising outpatient clinics, reducing the number of outpatient appointments, reducing missed appointments, supporting the implementation of a digital pre-assessment pathway and reducing phone calls using PKB key features.
Current Problems
Large waiting times
High missed appointment rates
No digital pre-assessment pathway
Patients attending unnecessary appointments
Appointments are lengthy and expensive
Patients have no control
Long waiting times for appointments
PKB solutions
Tools in every PKB deployment to support outpatient delivery
Use case
Reducing Missed Appointments
Patients who did not register for PKB had DNA rates of 6.23%, while those who did register DNA only 4.05% of their appointments - a 35% reduction. This is the data from millions of appointments over 12 months across 19 providers who store their appointment data in PKB.
By sending appointment letters digitally with a read receipt and adding appointment data to a patient's PKB record, organisations can give patients more chances to be aware of the appointment.
Triage/preassessment programmes
Hull University Teaching Hospitals implemented a digital pre-assessment pathway, sending questionnaires to patients via PKB to determine what level and type of interaction a patient needed before surgery. The answers are extracted and inputted to a local custom-built dashboard used by the Admin and Nursing team to triage patients. In just the pilot period:
Since starting the PKB pathway, no PKB patient has had an on-the-day cancellation
Reducing admin/appointments
Swansea Bay Dermatology Team prompts a patient within PKB when they need to book their blood tests. Once the test results are returned to the clinician, they conduct this review independently and inform the patient via PKB when their prescription is ready to collect and changes they may have made. They’ve had a 75% reduction in face-to-face outpatient appointments (reduced from 4 quarterly to 1 annual appointment). ‘Follow-up not booked’ list of patients eliminated (*reported pre-COVID19).
HUTH Rheumatology Healthcare Prescription Team uses PKB’s questionnaire feature to remind patients to book their blood test to reduce the amount of time the team currently spends printing and sending letters to each patient, as well as the follow-up phone calls to produce prescriptions and the cost of sending letters in the post. Approximately 46 hours per year (1.5 weeks) of admin time is saved and can be redeployed for other uses. The team aims to increase this to 2 full weeks of saved admin time.
Reducing calls
East Sussex - Uro-oncology Team
Using questionnaires to review patients every six months. The results go through to an admin who will triage the results. This used to be managed with a telephone appointment with every patient, asking questions and discussing concerns. This has caused a reduction of over 50% of telephone calls.
Swansea The Rheumatology team
Use PKB to allow patients to check their blood test results, which are automatically shared via the portal. Patients on disease-modifying drugs can securely use the portal to message the rheumatology team if they have queries. This has led to a 75% reduction in calls to the service’s advice line from patients with queries regarding their appointments or blood results.
Key features
There are key PKB features all services can use. A list of them is below.
Questionnaires
Teams can use PKB’s FHIR trigger API to automate sending questionnaires to service users, and they can use PKB’s FHIR API to extract completed responses back into their Organisation's electronic patient record (EPR) for review.
Patients can initiate a questionnaire by clicking start questionnaire on their homepage or directly within the NHS App. Once completed the questionnaire can be sent to a professional or team.
PKB's advanced questionnaire functionality
The features include:
Scoring and calculations
Branching, allowing patients to complete the parts of the questionnaire that are relevant to them
Coded fields questionnaires can be mapped to clinical codes
Patients can save drafts
Send questionnaires to patients who aren’t registered or already in your team
Questionnaire templates
Pre Op Questionnaire (preparing patients for their appointment)
Prehab - Healthy Eating Questionnaire
Quality of life questionnaires
Pain questionnaire
Messaging
Patients have access to message their healthcare team (saving time on the phone)
The Admin team can triage messages. Either resolving or passing onto another speciality team
Universal Messaging is the ability for patients to message clinical and non-clinical teams
Team-based messaging allows teams to automatically receive secure messages and questionnaires/consultations as a group rather than as individuals
Library
Waiting well information and support
Online patient leaflets
Support group information
Videos
Generic appointment information
Care plans
PKB care plans can be used at every stage of a patient's condition journey, below are some of the care plan templates being used and templates that can be created.
Living Well for Longer
Condition information and resource care plans
Monitoring condition plan (example cardiology monitoring care plan)
Rehab, physical activity and musculoskeletal health
Appointments
Appointment letters and appointments sent to PKB via integration
Manually entered appointments
SMART goals
Reduce the number of appointments for the ………. team by Sept 2024 (12 months post team go live) from (current appointments) to ( %) by adding all patients to a PIFU pathway (if they fit the criteria), schedule questionnaires to be sent ….. Current appointment rates are (%). 12 months post go live, the team compared appointment rates of patients with and without a PKB record. It is a local NHS priority to add patients to a digital PIFU pathway to reduce waiting lists and to save money.
Reduce the number of missed appointments (DNA) for the rheumatology team by Sept 2023 (12 months post team go live) from (current missed appointments) to ( %) by sending all appointment letters and appointment details into PKB instead of by post. Current missed appointment rates are (%). 12 months post go live, the team compared missed appointment rates of patients with and without a PKB record. It is a local NHS priority to reduce missed appointments to save money.